Provider Demographics
NPI:1619140159
Name:CARTER, DANIELLE ALEXIS (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:ALEXIS
Last Name:CARTER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MISS
Other - First Name:DANIELLE
Other - Middle Name:ALEXIS
Other - Last Name:ZUBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:8513 ROSEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-6638
Mailing Address - Country:US
Mailing Address - Phone:216-862-4194
Mailing Address - Fax:216-862-4194
Practice Address - Street 1:8513 ROSEWOOD AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-6638
Practice Address - Country:US
Practice Address - Phone:216-862-4194
Practice Address - Fax:216-862-4194
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH122112164W00000X
OHRN380525163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No164W00000XNursing Service ProvidersLicensed Practical Nurse